Evolving clinical landscape of chronic hepatitis B: A multicenter Italian study

• Published in: Journal of medical virology Vol. 81; no. 12; pp. 1999 - 2006
• Main Authors: Stroffolini, Tommaso, Almasio, Piero L, Sagnelli, Evangelista, Mele, Alfonso, Gaeta, Giovanni Battista
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.12.2009; Wiley
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Antibodies, Viral - analysis; Biological and medical sciences; cirrhosis; Cross-Sectional Studies; Female; Fundamental and applied biological sciences. Psychology; Geography; HBeAg; HDV; hepatitis B; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - epidemiology; Hepatitis B, Chronic - immunology; Hepatitis, Viral, Human - immunology; HIV - immunology; HIV Infections - complications; HIV Infections - immunology; Human viral diseases; Humans; Infectious diseases; Italy - epidemiology; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Prevalence; Viral diseases; Virology; Italy; Europe; hepatitis B; Multicenter study; HBeAg; Hepatic disease; Infection; Virus; Hepatitis B e antigen; Viral hepatitis B; Cirrhosis; Hepatitis D virus; Viral disease; Digestive diseases; HDV
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.21643

The aim of the study was to evaluate the characteristics of chronic hepatitis B with special reference to the geographical origin of the patients and to the prevalence of HBeAg and viral and non-viral co-factors of liver disease. A cross-sectional multicenter survey was undertaken, which enrolled 1,386 HBsAg chronic carriers observed consecutively in 21 referral centers over a 6-month period. The prevalence of HBeAg in patients was 11%; the presence of HBeAg was associated independently with a younger age and co-infection with HIV. Anti-HDV, anti-HCV, or anti-HIV antibodies were detected in 8.1%, 6.5%, and 2%, respectively. However, among the patients first diagnosed during the study period (incident cases), 14.3% were anti-HDV positive. Seven percent of the patients were immigrants; they were younger than Italian patients and 18% were HBeAg positive; no difference was observed in the prevalence of anti-HDV, anti-HCV, or anti-HIV antibodies. The presence of cirrhosis was associated independently with an age >52 years, the presence of anti-HDV or anti-HCV, alcohol use >4 drinks/day, and a high BMI. The clinical epidemiology of chronic hepatitis B virus (HBV) infection shows a dynamic profile, with the potential for re-emergence of cases with HBeAg or anti-HDV and an emerging impact of metabolic factors on the evolution of liver disease. J. Med. Virol. 81:1999-2006, 2009.